A curious question?

[angelburst29]

Recently, I had a close Family member admitted to the Hospital, then transferred to an upper floor Hospice, where he died several days later. While I was at the Nurse's Desk getting information as to when the Doctor had ordered an increase in medication, another Nurse came over an instructed the Nurse I was speaking to, to call downstairs for more IV bags, theirs were still on "back order."

After the Funeral, most in attendance gathered at a local Restaurant for a late Brunch. There was around 70 in our group, with 8 seated at each table. Across from me and down two seats was a close family friend who worked in ER at the Hospital. Directly across from him was my Daughter n-Law's Mother who is a Head Nurse/Supervisor at a Nursing Home. I don't know how the conversation got started but I overheard a good portion of it. They were talking about ObamaCare and how it affected their jobs since it went into affect. In the ER where he worked, they stopped performing "non-critical surgeries" mainly due to short supplies of essential medications and Saline IV Intravenous Bags. She mentioned, they don't use as many IV Bags - like they use to, the Dr's have been ordering muscular shots instead.

I'm not even sure why this seems important, other than my curiosity but I have search the net for any reports on short supplies of IV Bags and have found nothing. I don't even know what the significance would be for a shortage, if indeed, one exists?

I do know, ObamaCare has stripped away many procedures in Medicare/Medicaid especially for the elderly. As for medical supplies, the only thing that comes to mind, that many supplies are being shipped out of the Country - leaving us short changed due to the U.S.'s involvement in several conflicts aboard?

 

[mocachapeau]

I work in a hospital, not in the U.S. and not in the health field. I haven't heard anything about a shortage of IV bags but one thing is for sure, everything that is going on is about cutting spending. EVERYTHING! And what is also certain is that all the cuts, all the changes, directly effect the quality of care for the patient.

They try to cover that up by explaining that each new protocol, or method of operation, compensates for whatever lack they might foresee. But it doesn't. We, the employees at the bottom level, have so much more dumped on our backs every day that in many cases we are not able to handle the workload. It is not very difficult to see the effect when our hospital increases the yearly number of operations from 1000 to 1800, in the last 3 or four years, but the number of employees in the sterilization department is the same as it was 20 years ago.

That may not address your question directly but it may be a significant factor.

 

[Yupo]

The issue isn't so much ACA, but rather a confluence of many things leading to greatly increased costs of doing business and greatly reduced reimbursements. More changes in reimbursement models are coming. Soon. Yeah!

I just read a piece this morning that might affect access to federal subsidies on these already outrageously expensive ACA policies. This is from Uvadis website, a healthcare news aggregator.

Federal District Judge issues key ruling blocking certain provisions of the Affordable Care Act

18 May 16
CURATED BY
RSi Communications

In an unprecedented ruling, a Federal District Court judge has determined that the Department of Health and Human Services was never authorized to spend billions of dollars on provisions of the Affordable Care Act (ACA) that grant subsidies to lower-income Americans seeking insurance coverage under the new law.

As reported by The New York Times, Judge Rosemary Collyer’s decision affects funding for a provision of the ACA that assists as many as 7 million lower-income individuals with paying deductibles, co-pays, and other out-of-pocket expenses.

Collyer’s decision blocks further spending under the program, although her order has been stayed pending an appeal from the Obama administration. Should the decision be upheld, insurance companies stand to lose subsidies, which could drive up premiums and disrupt the health care industry at large.

 

[Chu]

I don't have an answer either, but that's scary... I think it's not just in the US, though in there it might be worse than in other countries. In France, you hear more and more of doctors refusing to prescribe some tests, because it "costs too much" to the SS system. I was talking to my dermatologist today, who is retiring in a couple of months, and she said that in our little town, we're going to have a BIG shortage of doctors and supplies if things keep going the way they've been going. The government put "quotas" on the number of doctors who can graduate each year, but that makes it so that most doctors now work in big cities, and in the smaller ones, all that remains are the doctors who were there before, and are soon retiring, with no young ones to replace them. And the government is limiting the budget at hospitals too.

Things like getting and MRI done have become a "luxury", unless you are in Paris.

So, yeah, maybe these are other signs of the times...

If they don't use as many IV bags, I wonder what effect it has on some patients! It's not the same as getting an intramuscular shot.

 

[Yupo]

What I am seeing (USA) are some under the radar gate closures. Want to order a special (pretty ordinary/routine and absolutely justified) test? OK. "Covered", but go through our (payor's) prior approval process in which we are highly likely to just say no. I've seen it become a 45 minute process at times. Who has that kind of time? Potentially life saving stuff being rejected for coverage because someone is 2 months too young. :(
Ditto medium/top tier medication access.
Some of the good programs to help people are becoming so convoluted that access getting to be unlikely because of reluctance of physicians to take on the paperwork and blow-back risks, such as increased chance of Medicare audits.
The small time and small town providers and patients are feeling the brunt of all of it. Bigger organizations, hospitals, large group practices, etc. have special staff just to deal with this stuff. Everyone I know well in the industry of middle age or so wants to quit, find a different career.
It is a sad situation for everyone. I don't see it getting better.

 

[Garuda]

I don't have an answer either, but that's scary... I think it's not just in the US, though in there it might be worse than in other countries. In France, you hear more and more of doctors refusing to prescribe some tests, because it "costs too much" to the SS system.

In Spain the social security doctors income depend on the number of tests they prescribe. If they are above their quote, they wages are reduced.

 

[Yupo]

If they are above their quote, they wages are reduced.

Behavior modification. Expect to see more of it.

 

[Leland]

I remembered reading about this and it has been covered in a few outlets (but certainly not mainstream news) for several years now. It's even even gotten the attention of some of our illustrious leaders.

Just keep in mind congress held hearings about the lack of minerals in the soil, back in the 1930s....
__http://rogerldavis.com/minerals-1936-congressional-records

Lots of articles and opinions within each, as to what the cause is.

Shortage Of Saline Solution Has Hospitals On Edge
__http://www.npr.org/sections/health-shots/2014/06/22/323679204/shortage-of-saline-solution-has-hospitals-on-edge

There’s a national shortage of saline solution. Yeah, we’re talking salt water. Huh?
__http://fortune.com/2015/02/05/theres-a-national-shortage-of-saline/

FDA updates on saline drug shortage
__http://www.fda.gov/Drugs/DrugSafety/ucm382255.htm

Senators Seek FTC Probe of Drug Makers Over Saline Shortage
__http://www.wsj.com/articles/senators-seek-ftc-probe-of-drug-makers-over-saline-shortage-1445898445

Shortage Of Saline Solution Has Hospitals On Edge
__http://www.npr.org/sections/health-shots/2014/06/22/323679204/shortage-of-saline-solution-has-hospitals-on-edge

Saline shortages create troubles for U.S. hospitals
__http://www.pbs.org/newshour/rundown/saline-shortages-create-troubles-u-s-hospitals/

 

[Dirgni]

I don't have an answer either, but that's scary... I think it's not just in the US, though in there it might be worse than in other countries. In France, you hear more and more of doctors refusing to prescribe some tests, because it "costs too much" to the SS system.

In Spain the social security doctors income depend on the number of tests they prescribe. If they are above their quote, they wages are reduced.

In Germany they have a flat rate per case and if the doctor wants to give a patient more he does not get paid for it or has to pay himself for this. Last year when my mother was in hospital recovering from an operation because of her broken shoulder, she was asked insistently by the doctor when she will go home. Hey, she has one of the better health insurances available here. I also heard there were less doctors in the country. When old doctors retire, there are no successors any more. I read that whole hospital stations were closed because hospitals have to be profit-making companies nowadays. Some time ago I read an article that parents have to drive on the other side of Munich to bring their children to a pediatrician. Pediatricians nearer to their homes rejected them because they already have too many little patients. Munich does not want to have more pediatricians and doctors practice are not allowed to hire additional pediatricians even if there is more work than the doctor can possibly do. Sign of the times. Profit is more important than people.

 

[Yupo]

Shortage Of Saline Solution Has Hospitals On Edge
__http://www.npr.org/sections/health-shots/2014/06/22/323679204/shortage-of-saline-solution-has-hospitals-on-edge

There’s a national shortage of saline solution. Yeah, we’re talking salt water. Huh?
__http://fortune.com/2015/02/05/theres-a-national-shortage-of-saline/

FDA updates on saline drug shortage
__http://www.fda.gov/Drugs/DrugSafety/ucm382255.htm

Senators Seek FTC Probe of Drug Makers Over Saline Shortage
__http://www.wsj.com/articles/senators-seek-ftc-probe-of-drug-makers-over-saline-shortage-1445898445

Shortage Of Saline Solution Has Hospitals On Edge
__http://www.npr.org/sections/health-shots/2014/06/22/323679204/shortage-of-saline-solution-has-hospitals-on-edge

Saline shortages create troubles for U.S. hospitals
__http://www.pbs.org/newshour/rundown/saline-shortages-create-troubles-u-s-hospitals/

Don't know if it relates or not, but when the Ebola thing was going on recently, there was a lot of talk of shortages because (rumored) hoarding/overstocking of it by facilities. The issue now is most likely one of keeping inventory (of everything) very low as a cost-saving measure. OK, that's great if next day delivery is up and running everywhere. If something bad happens to affect a good size area (EMP, major earthquake, whatever), heaven help us.

 

[Aliana]

Hospital ER's have been reporting shortages and unavailability of a variety of drugs:

Critical Drugs For Hospital ERs Remain In Short Supply
_http://www.npr.org/sections/health-shots/2016/05/02/476486009/critical-drugs-for-hospital-ers-remain-in-short-supply

According to a new study, shortages of many drugs that are essential in emergency care have increased in both number and duration in recent years even as shortages for drugs for non-acute or chronic care have eased somewhat. The shortages have persisted despite a federal law enacted in 2012 that gave the Food and Drug Administration regulatory powers to respond to drug shortages, the study found.

For this report, which was published in the May issue of Health Affairs, researchers analyzed drug shortage data between 2001 and 2014 from the University of Utah's Drug Information Service, which contains all confirmed national drug shortages, according to the study.

They divided the drugs into acute and non-acute categories. Acute-care drugs were those used in the emergency department for many of the urgent and severe conditions handled there and include remedies such as pain medications, heart drugs, saline solution and electrolyte products.

[...]

Seventy percent of the drugs that were difficult to get were injectable drugs, which emergency departments rely on to a much greater degree than other types of providers. The most common acute-care drugs affected were those to fight infections, such as antibiotics; those that affect the central nervous system, including painkillers and sedatives; and the drugs that suppress or stimulate the autonomic nervous system, which controls heart and breathing rates.